Provider Demographics
NPI:1518941491
Name:WINTERS, GLORIA RENEE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:RENEE
Last Name:WINTERS
Suffix:
Gender:F
Credentials:DPT
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Mailing Address - Street 1:1330 QUAIL LAKE LOOP
Mailing Address - Street 2:PT WORKS PC CHEYENNE MTN CLINIC
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4651
Mailing Address - Country:US
Mailing Address - Phone:719-579-0230
Mailing Address - Fax:719-579-0277
Practice Address - Street 1:1330 QUAIL LAKE LOOP
Practice Address - Street 2:PT WORKS PC CHEYENNE MTN CLINIC
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4651
Practice Address - Country:US
Practice Address - Phone:719-579-0230
Practice Address - Fax:719-579-0277
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO76772251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
441878Medicare ID - Type Unspecified